Provider Demographics
NPI:1134119951
Name:DOGGETT, KAREN (ARNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DOGGETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 EASTPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4185
Mailing Address - Country:US
Mailing Address - Phone:502-736-3636
Mailing Address - Fax:502-736-3637
Practice Address - Street 1:207 SPARKS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-0600
Practice Address - Country:US
Practice Address - Phone:812-284-4357
Practice Address - Fax:502-736-3637
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1051837363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP71761Medicare UPIN
KY0735302Medicare ID - Type Unspecified